Early Diagnosis and Treatment of Familial Hypercholesterolemia

The VRONI study

2

•Familial Hypercholesterolemia (FH)

Nordestgaard, B.G., et al., Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease:

consensus statement of the European Atherosclerosis Society. Eur Heart J, 2013. 34(45): p. 3478-90a.

3

•FH is a common disease!

2021 © VRONI | ALL RIGHTS RESERVED

autosomal dominant

• Prevalence of FH is 1:250

• 14-34 millions of FH patients worldwide

• in most of countries FH is diagnosed in

<1% of the patients

Germany ???

Nordestgaard, B.G., et al., Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population Eur Heart J, 2013.

Schmidt et al Atherosclerosis 2017

➢ Who ?

➢ Every child in Bavaria, voluntary and free of charge

➢ When?

➢ Aged 5-14 years, in the context of regular preventive checkups (U9-

J1)

➢ How?

➢ 200µl of capillary or venous blood

•Early diagnosis by measuring LDL-Cholesterol

52021 © VRONI | ALL RIGHTS RESERVED

Follow-up visits

VR

ON

I d

ata

ba

se

VRONI study center: Data Management, organisation and administration

LaboratoryLDL-Cholesterol measurement

Negative result: LDL-C < 130 mg/dl

Positive result: LDL-C ≥ 130 mg/dl

Genetic analysis

Children with FH mutation(s)Children without FH

mutations

Further diagnostics

Paediatric cardiologist

Specialized training center

Paediatricians Informed

consent Blood sample

Screening: Bavarian children aged 5-14 years

7

•FH, so what!

2021 © VRONI | ALL RIGHTS RESERVED

Medical care by pediatricians

and cardiologists

Specialized Training center

8

•VRONI … „the cool kid“

2020 © VRONI | ALL RIGHTS RESERVED

Information booklet:

VRONI – my life with FH!Homepage: myvroni.de

9

•VRONI Milestones

2021 © VRONI | ALL RIGHTS RESERVED

StudydocumentsRevison

Legal

Examinations

BVKJ

cooperationEthical

approval

Studydocuments

V1.0

Databasefirst Iteration

GEKO

Training

concept

PR-campaign

Vroni-Information

booklet

CaRe High

Cascade Screening

Vroni-Kick offWebinar

Starter Pakages

goes to doctors

Data Protection

First samples

Sample Monitoring

Press releases

20182021

10

•VRONI Infrastructure

2021 © VRONI | ALL RIGHTS RESERVED

11

•VRONI Network

2021 © VRONI | ALL RIGHTS RESERVED

12

•VRONI present status

2021 © VRONI | ALL RIGHTS RESERVED

1150 children enrolled

295 participating pediatricians

112 with LDL >130 mg/dl

13

•Sample number over time

2018 © VRONI | ALL RIGHTS RESERVED

total number of samples

samples with LDL>130 mg/dl

14

•VRONI Aims

2021 © VRONI | ALL RIGHTS RESERVED

▪ Early diagnosis and treatment reduce risk for early

atherosclerotic manifestations

▪ Establish Cascade Screening to detect other relatives

▪ Evaluate the feasibility of population-based-screening for

FH in children

▪ Identification of new FH-Mutations

➢ Improve managment and treatment of FH in patientsto prevent manifestation of atherosclerotic disease!

15

•Outlook

2021 © VRONI | ALL RIGHTS RESERVED

EDUCATIONHealthy lifestyle with FH

FH-Booklet

PREVENTIONEarly diagnosis and

treatment reducecardiovascular risk

RESEARCHDetection of new FH mutations

VUS: Functional examinations

ECONOMIC ASPECT

Decrease of heart attacks andhospitalization

Integration of FH-Screening in standard care

www.myvroni.de

16

Together against Hypercholesterolemia !!!